The Department of Veterans Affairs (VA) provides care to nearly four million veterans. African-American and Latino veterans, compared with white veterans, are more likely to depend on the VA to provide all or some of their healthcare. Outside of VA settings, racial/ethnic disparities have been noted for access to and quality of healthcare. These racial/ethnic disparities are associated with worse health outcomes and the presence of unmet healthcare needs. Much research has focused on the crucial role of medical insurance in assuring access to non-emergency department based ambulatory care services. However, factors beyond insurance coverage also significantly impact access to care and health outcomes. The VA, which offers access to healthcare for all eligible veterans, is an ideal system to examine factors beyond medical insurance that are associated with variations in the process and outcomes of care. Additionally, because the VA promotes and monitors process of care quality indicators for select medical conditions and prevention measures, it provides an opportunity to examine quality indicator monitoring as a method for reducing racial/ethnic disparities in process and outcomes of care. Specific Aim 1 is to determine the association between patient race/ethnicity and process of care relative to national standards. Specific Aim 2 is to assess the impact of VA monitoring of process of care quality indicators on racial/ethnic disparities in process and outcomes of care. To address these specific aims, we will compare receipt of guideline-adherent care for diabetes mellitus, cardiovascular disease, and cancer screening by racial-ethnic group. This cross-sectional study will combine data from a variety of existing research and VA administrative databases to create the analytic dataset for this secondary data analysis. Racial/ethnic disparities in receipt of guideline-adherent care will be contrasted for VA-monitored and non-monitored process of care quality indicators for these conditions.